双能CT结肠成像部分自动个体化充注空气扩张结直肠的研究  

Study on colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography

作　　者：梁丹[1,2] 郭红梅 段侪杰[4] 罗明月[2] 朱冬云[2] 邱建平[2] Wenli Cai Liang Dan Guo Hongmei Duan Chaijie Luo Mingyue Zhu Dongyun Qiu Jianping Wenli Cai(Department of Radiology, Guangzhou First People rs Hospital, Guangzhou, Guangdong 510180, China Department o3c Radiology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, China Department of CT and MR ,Mongolia Autonomous Prefecture People＇s Hospital of Ba yinguoleng ,Kuerle,the Xinjiang Uygur Autonomous Region 841000, China Research Center of Biomedical Engineering ,Graduate School at Shenzhen, Tsinghua University, Shenzhen, Guangdong 518055, China Department of Radiology, Massachusetts General Hospital and Harvard Medical School ,Boston,Massachusetts 02114,the United States)

机构地区：[1]广东省广州市第一人民医院放射科,510180 [2]中山大学附属第六医院放射科,广州510655 [3]巴音郭楞蒙古自治州人民医院CT和MR科,新疆库尔勒841000 [4]清华大学深圳研究生院生物医学工程研究中心,广东深圳518055 [5]哈佛大学医学院麻州总医院放射科,马萨诸塞州波士顿02114

出　　处：《重庆医学》2017年第14期1897-1899,1903,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81230035);广东省科技计划项目(2013B051000016)

摘　　要：目的研究双能CT结肠成像部分自动个体化充注空气扩张结直肠受检者依从性及结直肠充气扩张效果。方法选择46例没有影响胃肠道运动功能病史的健康成年志愿者,CT检查前1d开始5次口服4.0%泛影葡胺60mL标记肠内容物。利用充气机部分自动、个体化充注空气扩张结直肠,充气体位先右侧卧位,再缓慢改为仰卧位,速率开始为1.5L/min,后期降低到0.5L/min,并根据侦察图像结直肠充气扩张效果、志愿者自我感觉及肠腔压力确定是否需要增补充气及充气量。仰卧位双能CT扫描,获得双能融合图像。统计分析志愿者的依从性,Kruskal-Wallis H检验比较结直肠充气扩张效果。结果 46例志愿者均没有腹痛、腹胀、恶心或呕吐等,容易接受结直肠充气扩张,依从性1级。结直肠充气扩张1、2、3、4级效果分别占0%、2.1%、5.1%、92.8%。结直肠各段肠管充气扩张效果比较差异无统计学意义(χ~2=6.19,P=0.288)。6段肠管充气扩张差,乙状结肠、直肠各占2段。14段肠管充气扩张欠佳,降结肠、乙状结肠、直肠分别占4、4、3段。结论部分自动个体化充注空气扩张结直肠受检者依从性非常好,能够良好地充气扩张结直肠各段肠管。Objective To study the compliance of examinees,and effectiveness of colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography. Methods Forty-six healthy adult volunteers without history of conditions affecting gastrointestinal motor function were enrolled in this study. One day before CT examination, volunteers were asked to orally administered 60 mL 4 % diatrizoate meglumine five times for fecal tagging. Air was insufflated by using an inflator in a partially automated and individualized manner. The volunteers were initially asked to assume the right lateral decubitus position, then slowly turn to the supine position. Insufflation rate began at 1.5 L/min, and decreased to 0.5 L/min at later stage. The necessity and volume of air insufflation were decided according to effectiveness of colorectal distension on CT scout images, self-reported sensation of volunteers,and intestinal pressure. Dual-energy CT scanning was performed, and dual-energy blended ima- ges were acquired. Compliance of volunteers was statistically analyzed. The effectiveness of cotorectal segments distension was sta- tistically analyzed by using Kruskal-Wallis H test. Results No abdominal pain,bloating, nausea or vomiting were noted in the 46 volunteers. All volunteers easily accepted colorectal insufflation of air,with grade 1 compliance. The effectiveness of colorectal distension of grades 1,2,3 and 4 were 0%, 2.1%, 5.1% and 92.8%, respectively. The difference of effectiveness of colorectal segments distension had no statistical significance（x2 = 6.19 ,P=0. 288）. The effectiveness of insufflation was poor in 6 colorectal segments,including 2 in sigmoid colon and 2 in rectum. Effectiveness of insufflation was suboptimal in 14 colorectal segments,including 4 in descending colon,4 in sigmoid colon,and 3 in rectum. Conclusion Compliance of examinees with partially automated and individualized insufflation of air for dual-energy CT colonography is excellent,with good effectiveness of c

关 键 词：结肠 直肠 体层摄影术 X线计算机 双能CT结肠成像 结直肠扩张 部分自动 个体化充气 空气 

分 类 号：R816.5[医药卫生—放射医学]